The effectiveness of adding cognitive behavioural therapy aimed at changing lifestyle to managed diabetes care for patients with type 2 diabetes: design of a randomised controlled trial

Background  

In patients with type 2 diabetes, the risk for cardiovascular disease is substantial. To achieve a more favourable risk profile, lifestyle changes on diet, physical activity and smoking status are needed. This will involve changes in behaviour, which is difficult to achieve. Cognitive behavioural therapies focussing on self-management have been shown to be effective. We have developed an intervention combining techniques of Motivational Interviewing (MI) and Problem Solving Treatment (PST). The aim of our study is to investigate if adding a combined behavioural intervention to managed care, is effective in achieving changes in lifestyle and cardiovascular risk profile.     

HPLC同时测定苦豆子中槐定碱、氧化槐果碱和氧化苦参碱的含量

目的：建立同时测定苦豆子中槐定碱、氧化槐果碱及氧化苦参碱含量的HPLC测定法。方法：色谱柱为Phenomenex Gemini C₁₈(46 mm×250 mm,5 μm),以甲醇(A)-02%磷酸水(B)为流动相,检测波长205 nm,流速1 mL·min^-1,柱温30 ℃。结果：在线性范围内3个对照品的标准曲线呈良好的线性关系(r≥0999 7)。平均回收率分别为1000%,970%,970%。结论：可通过HPLC同时测定苦豆子中槐定碱、氧化槐果碱和氧化苦参碱的含量,并可用该方法进行苦豆子药材的质量控制。     

Tamoxifen Therapy for Breast Cancer and Endometrial Pathology

Background

Tamoxifen, used as adjuvant therapy for carcinoma breast in postmenopausal women to prevent relapse has estrogenic effect on the endometrium.

Methods

104 patients on tamoxifen for more than six months were subjected to a clinical examination and transvaginal sonography. Patients with endometrial thickness > 8 mm were further evaluated by hysteroscopy and endometrial biopsy.

Results

35(34%) patients were symptomatic. The average endometrial thickness was 11.2 mm which correlated with duration of tamoxifen use. 27(48%) patients had abnormal hysteroscopic findings. 35 (63%) of endometrial biopsies revealed abnormal endometrium. One case of endometrial carcinoma was diagnosed. The results were statistically analysed. There is a significant association between symptomatic status and endometrial thickness and duration of tamoxifen use.

Conclusion

All patients on long term tamoxifen should be annually screened for endometrial pathology.Key Words: Tamoxifen, Endometrium, Transvaginal sonography     

Histological analysis of rat dental pulp tissue capped with propolis

The aim of the present study was to assess the response of rat dental pulp to direct pulp capping with propolis. Flavonoid and non-flavonoid materials were purified from an ethanol extract of propolis obtained from South Sulawesi, Indonesia. A Class I cavity was prepared on the occlusal surface of the right maxillary first molar in Sprague Dawley rats. The dental pulp was exposed and then capped with a zinc oxide-based filler as a control (group I), or with propolis flavonoids (group II) or non-flavonoids (group III). The animals were sacrificed at week 1, 2 or 4, biopsy samples were obtained, and these were stained and viewed by light microscopy. The results showed that pulp inflammation occurred in groups I and III as early as week 1. No dentin bridge formation was seen in these groups. In contrast, there was no evident inflammatory response in group II at week 1. Mild and moderate pulp inflammation in this group occurred at 2 and 4 weeks after treatment, respectively. Partial dentinal bridge formation was seen in group II at week 4. Therefore, the present results suggest that direct pulp capping with propolis flavonoids in rats may delay dental pulp inflammation and stimulate reparative dentin.     

Placement of Umbilical Artery Catheters High vs. Low

Placement of umbilical artery catheters was retrospectively reviewed in 181 newborns to evaluate random placement of catheter tip in the "high" position between T₇ and T₉ in the thoracic aorta of 127 infants and in the "low" position below 4 in the abdominal aorta of 54 infants. Group differences in gestational age, asphyxia, hypotension, respiratory disease, duration of catheterization, or infusate type were not significant. Cyanosis or blanching in the low extremities occurred in 67% of the "low" group and 21% of the "high" group ( P < .001). Hematuria occurred in 39% of the "low" group and 21% of the "high" group ( P < .05). High placement appears to have fewer complications. Prompt intervention by neonatal nurse practitioners can help reverse complications that occur during umbilical artery catheterizations.